Provider Demographics
NPI:1700609435
Name:BENNY, ANN MARIA (AUD)
Entity type:Individual
Prefix:DR
First Name:ANN
Middle Name:MARIA
Last Name:BENNY
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:DR
Other - First Name:ANN
Other - Middle Name:BENNY
Other - Last Name:STEPHEN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:AUD
Mailing Address - Street 1:681 MANOR CT
Mailing Address - Street 2:
Mailing Address - City:DES PLAINES
Mailing Address - State:IL
Mailing Address - Zip Code:60016-2955
Mailing Address - Country:US
Mailing Address - Phone:847-858-7792
Mailing Address - Fax:
Practice Address - Street 1:267 E WESTMINSTER
Practice Address - Street 2:
Practice Address - City:LAKE FOREST
Practice Address - State:IL
Practice Address - Zip Code:60045-1853
Practice Address - Country:US
Practice Address - Phone:847-295-1185
Practice Address - Fax:847-295-1165
Is Sole Proprietor?:No
Enumeration Date:2024-11-01
Last Update Date:2024-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL147.002023231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist